Self-neglect

Self-neglect is a behavioural condition in which an individual neglects to attend to their basic needs, such as personal hygiene, appropriate clothing, feeding, or tending appropriately to any medical conditions they have.[1] Extreme self-neglect can be known as Diogenes syndrome.

Contents

Causes of self-neglect

Self-neglect can be as a result of brain injury, dementia or mental illness.[2] It can be a result of any mental or physical illness which has an effect on the person's physical abilities, energy levels, attention, organisational skills or motivation.

A decrease in motivation can also be an unfortunate side effect of necessary psychiatric medications, leading to those requiring them being at higher risk of self neglect than might be caused by their illness alone.[1][3]

Consequences of self-neglect

Because of lack of hygiene, sores may develop and minor wounds may become infected. Any health problems may be exacerbated, due to insufficient attention being paid to them by the individual. Lack of sufficient personal hygiene may mean that the person suffers social difficulties and isolation.

Self-neglect can also lead to the individual having a general reduction in attempts to maintain a healthy lifestyle, with increased smoking, drug misuse or lack of exercise.[3]

Any mental causes of the self-neglect may also lead to the individual refusing offers of help from medical or adult social services.

Treatments

Treatment may involve treating the cause of the individual's self-neglect, with treatments such as those for depression, dementia or any physical problems that are hampering their ability to care for themselves.

The individual may be monitored, so that any excessive deterioration in their health or levels of self-care can be observed and acted upon.[4]

Treatment can involve care workers providing home care, attending to cleansing, dressing or feeding the individual as necessary, without reducing their independence and autonomy any more than is essential.[5]
In combination with other illnesses, self-neglect may be one of the indicators that a person would be a candidate for treatment in sheltered housing or residential care. This would also improve their condition by providing opportunities for social interaction.

If the person is deemed not to have the mentalcapacity to make decisions about their own care, they may be sectioned[6] or compelled to accept help. If they are in possession of their mental faculties, they have a right to refuse treatment.

Use in assessment of needs

Neglect of hygiene is considered as part of the Global Assessment of Functioning, where it indicates the lowest level of individual functioning. It is also part of the activities of daily living criteria used to assess an individual's care needs. In the UK difficulty in attending to their own physical cleanliness or need for adequate food are part of the criteria indicating whether a person is eligible for Disability Living Allowance.